Northfield Hospital Board Meeting Sept. 2018


  1. Chair, Charlie Mandile, called the meeting to order at 6:35 p.m. The Agenda was approved.

A correction was made to the Minutes of the August Board Meeting, and then the Consent Agenda was approved.  The Consent Agenda included Minutes for the August Board Meeting, Minutes for a Community Relations Committee Meeting, Minutes for a Special Governance and Planning Committee Meeting, and the Annual Review of Quality & Performance Improvement Policy.


  1. Chief Medical Officer—Jeff Meland. There are space needs for the physicians. The applications for Medical Staff Membership/Privileges were approved.
  2. City Report—Brad Ness. The City Council met Monday and approved $300,000 for tree cleanup following the storm.Pickup will start Oct. 8. See the City website for details.  The tax levy for 2019 will increase by 7% or less.


Presentations/Discussions/Action Items

  1. ENT Sinus Navigation System—Jerry Ehn. (Second presentation) Ehn reviewed the details from the first presentation. The cost, $155,424 will be reduced by $75,000 as NH&C will receive credit for the rent paid on the machine thus far in 2018. Final cost: $81,424. The Board approved the purchase.
  2. Revision of Foundation Bylaws—Laura Peterson. The document brought by Peterson sparked an extensive discussion regarding the relationship between the Hospital Board, the Foundation Board, and the Foundation. The Hospital Board indicated that they wanted a closer relationship with the Foundation, and suggested several changes. Revised Bylaws will be brought to the Board at the Oct. meeting.


Strategic Discussion

  1. Clinic /OB Space Challenges—Jerry Ehn. The lack of space on campus is limiting growth; the funding available in the capital budget is relatively small. Top priority was given to expanding the Medical Clinic and the Birth Center. The Clinic is the source of referrals for other services. The Birth Center is viewed as a high-growth service.  The proposal is to a) construct clinic space adjacent to the north side of the existing clinic, and b) to construct birthing space adjacent to the east side of the current Birthing Center. The Administration is proposing to use “contractor design and build” project management in the hope of fitting the cost within a budget of $12 million.  Ideally, ground breaking would be in June of 2019, but that is a very tight schedule since both the City and St Olaf College need to approve the projects after the Board approves them.  Extra Board meetings may be required to meet the time schedule.
  2. Midwifery Program—Jerry Ehn. NH&C is considering a hospital-based midwife program. Patients are requesting midwife services and some potential patients are choosing other sites to give birth.  The Administration is working with physicians and staff to define the potential service.  Next steps would be to evaluate consumer demand and to prepare a financial analysis of the service.  If the service appears viable, a midwife could be added to hospital staff and service would begin in early 2019.


Executive and Committee Reports

  1. CEO Report—Steve Underdahl. Work and progress continues on a wide variety of projects:  a) NH&C continues to study the options for electronic health records (EHR).  b) A work group has been established to move “patient facing technology” forward.  c) There was a board meeting of the Accountable Care Organization. Annual visit encounters have increased from zero to about 13.5% since the ACO program began.  The target is 30%.  d) The CEO is conducting the annual individual meetings with all providers in NH&C.  e) The governance meetings between the City and NH&C are continuing.  Committee members testified to the benefits from the discussions. “Relationships take work.” f) Mental health patients warehoused at NH&C continue to be a problem as the facility can’t provide appropriate treatment and must maintain a 1:1 staffing ratio with these patients, which is very expensive.  It was estimated that 3 – 5 mental health patients appear in the Emergency Room each day. g) There are many health-related issues being raised for the November elections, including Medicare For All—a slogan in search of a policy. Unfortunately voters and politicians are as sharply divided on health issues as they are on the other issues.  With no middle ground, a change is policy is unlikely.  h) A draft of the PERA white paper is circulating and the affected hospitals are working to build a coalition.
  2. Financial Report—Scott Edin. August was a good month. Net Operating Income was $525,000, which was over twice the amount budgeted. Most service categories were higher than expected.  Income from operations is $1.8 million YTD for 2018.
  3. Budget and Finance Committee—Charlie Kyte. The committee is revising its job description to include overseeing investments and reviewing extraordinary grant requests.The threshold for review of capital spending requests will be increased for $1000 to $5000.
  4. Governance and Planning Committee—Charlie Mandile. A special meeting on the CEO Evaluation Process was held. a)Input regarding CEO performance from Board members exiting the Board will be gathered, summarized, and reported, but not used in numerical form.  b) It was proposed to pay the CEO 6 months of base salary if s/he is fired at a “Change of Control,” and the CEO would agree not to exit prior to the occurrence of the change in control.  c) It was proposed to pay the CEO’s regular salary during the 90-day waiting period for long-term disability insurance coverage to take effect.  These proposals will come to the Board for a vote at a later meeting.


Charley Kyte thanked Vicki  Stevens for her work with a Torch student from Northfield High School interested in a health care career.

Meeting adjourned at 9:15 p.m.

Next meeting:  Oct. 25, 2018

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